Swelling of the lungs symptoms
Mar 04, 2018
Pulmonary edema occurs due to the release of the liquid portion of blood from the vascular bed through the alveolar-capillary wall into the airway of the lung with increasing blood pressure in the pulmonary veins and capillaries or as a result of increased permeability of the alveolar-capillary wall. Most often, pulmonary edema develops as a result of acute left ventricular failure with a rapid increase in blood stasis in pulmonary veins and an increase in pressure in them, requiring immediate medical attention, is the accumulation of fluid in the lungs. The most common pulmonary edema is the result of congestive heart failure and occurs when the heart loses its ability to pump blood through the arteries at the same rate as blood returns to the heart through the veins. Left-sided heart failure( left ventricle) leads to the accumulation of blood in the veins of the lungs( pulmonary veins), causing a dangerous increase in blood pressure in them. Constant high pressure in the pulmonary veins eventually leads to the fact that part of the liquid phase of the blood is forced into the neighboring microscopic air sacs( alveoli), which transfer oxygen to the blood. Since the alveoli are filled with a liquid, they can no longer supply the necessary amount of oxygen to the body. Symptoms, especially severe breathing difficulties, develop within a few hours and can be life threatening. If you start treating the underlying disease in time, the outlook for the outcome of pulmonary edema is quite optimistic, but overall the outcome of the disease depends on the nature of the underlying disease. The most frequent pulmonary edema is observed in adults with a high risk of developing heart failure.
This condition is close in nature and manifestations to cardiac asthma. Pulmonary edema is observed with myocardial infarction, atherosclerotic cardiosclerosis, mitral stenosis, hypertension, especially with hypertensive crises. Occurrence of pulmonary edema can be facilitated by infectious diseases associated with severe intoxication, croupous pneumonia, especially in old age.
A less common form of the disease is high-altitude pulmonary edema( which can occur during ascent of a mountain), which is also life-threatening if the patient is not quickly helped. Strenuous activity immediately after lifting to a high altitude can cause a dangerous increase in pressure in the pulmonary veins, which will lead to the displacement of fluid from the veins into the alveoli. Once a person acclimates, tense activity will not create such a risk. High-altitude pulmonary edema is most often observed in young people under the age of 25 who have good health, but did not manage to adapt to altitude. Symptoms occur within 24 to 72 hours and require immediate descent to lower heights for treatment.(Those who travel by air are usually not exposed to this danger, as aircraft cabinets are sealed.)
Pulmonary edema usually develops when there are clinical signs of a underlying disease that causes acute heart failure. Often in patients and before swelling there is shortness of breath at rest. With the onset and increase of pulmonary edema, dyspnea is greatly increased, a cough appears, usually with the release of a large amount of foamy sputum, sometimes pink. The patient takes a semi-sitting position in bed. Skin pale with cyanotic shade, moist. Breathing is sharply increased. In the lungs, a large number of humid various rales are heard, breathing is intensified. Pulse sharply increased, usually weak filling. Blood pressure is often lowered. Clinically and electrocardiographically, the signs of the corresponding heart disease are determined. Radiographically, large or small areas of infiltrative similar changes in pulmonary tissue are usually detected. Pulmonary edema can be characterized by acute course with a rapid increase in clinical manifestations, threatening the life of the patient. However, a less severe subacute and prolonged course of pulmonary edema is possible. The latter is especially characteristic for edema developing against a background of chronic cardiac or renal insufficiency. The resulting disruption of gas exchange in the lungs leads to significant shifts in the acid-base state with the development of initially respiratory acidosis.
Pulmonary edema can also occur as a result of toxic damage to the alveolar-capillary walls due to the inhalation of nitrogen oxides, warfare agents, pesticides. In its origin, pulmonary edema in chronic uremia, renal or diabetic coma, and allergic pulmonary edema approach this pathology. Manifestations of pulmonary edema in these cases are similar to those of left ventricular failure. However, a clinically more favorable course with a little-expressed dyspnoea, a small number of wheezing can also occur in the presence of sharply expressed radiologic signs of pulmonary edema. Clinically, usually the prevailing manifestations of the underlying pathology that caused swelling. It is important to bear in mind that for some intoxications( for example, nitrogen oxides) between the inhalation of toxic substances and the appearance of signs of pulmonary edema there may be a sufficiently long latent period, sometimes reaching a day.
Acute pulmonary edema due to left ventricular failure requires urgent medical interventions. Therapy begins with the introduction of narcotic analgesics - morphine( 1 ml of a 1% solution) or pantopone. They give a sedative effect and reduce the overexcitation of the respiratory center. At the same time, ganglion blockers are injected into the veins: 0.5-1.5 ml of a 5% solution or 2% benzogexonium solution, which help to decrease the pressure in the pulmonary vessels, the deposition of blood in the large circulation. To reduce the volume of circulating blood and discharge the small circle of circulation, diuretics are indicated: furosemide( 40-80 mg) or uretit( 50-100 mg), which are injected with iv, dissolved in glucose or isotonic sodium chloride solution. To improve the contractility of the myocardium and improve the outflow of blood from the lungs, the introduction of cardiac glycosides - strophanthin( 0.5-1 ml of a 0.05% IV solution with 10 ml of a 40% solution of glucose) is indicated. At the same time, usually enter euphyllin( 5-10 ml of a 2.4% solution) to reduce the concomitant pulmonary edema of the bronchospasm. Permanent oxygen inhalation is necessary. In order to reduce the abundant foaming that hampers the ventilation of the lungs, inhalations of alcohol vapors or antiphosilane are indicated. To this end, oxygen from the cylinders is passed through a humidifier, into which alcohol is poured instead of water. For faster removal of the phenomena of pulmonary edema, in addition to these drugs, the following measures are applied: the attachment of bundles to the extremities for the deposition of part of the blood in them, the bleeding of 300-500 ml of blood. Their goal is to reduce the amount of circulating blood and inflow it to the lungs by depositing part of the blood in the limbs.
Treatment of pulmonary edema caused by various diseases of the cardiovascular system, has some peculiarities. With myocardial infarction, which proceeds not only with pulmonary edema, but also with the phenomena of collapse, bloodletting is unacceptable. When swelling of the lungs against a background of hypertensive crisis, the introduction of active antihypertensive drugs, for example, aminazine( 1-2 ml).To reduce the increased permeability of the alveolar-capillary walls, 1-2 ml of a 2.5% solution of pipolpene, 40 ml of a 10% solution of calcium chloride, in hospital conditions 50-100 mg of hydrocortisone are injected into the vein. These same drugs have some significance for preventing the development of toxic pulmonary edema after inhalation of toxic substances. For the therapy of toxic pulmonary edema, it is important to administer diuretics, oxygen, according to the indications of vascular preparations. What folk remedies to use with this disease look here.